presentation - Status of Women Council of the NWT

Sexual Health
Caroline Newberry, RN BScN
Communicable Disease Specialist
GNWT, Department of Health & Social Services
Amy Lea, RN BScN
Public Health Officer, Public Health Agency of Canada
Department of Health & Social Services – NWT Sexual Health Program
March 2011

What is Sexual Health?
Sexual health is a state of physical, emotional,
mental and social well-being in relation to
sexuality; it is not merely the absence of disease,
dysfunction or infirmity. Sexual health requires a
positive and respectful approach to sexuality and
sexual relationships, as well as the possibility of
having pleasurable and safe sexual experiences,
free of coercion, discrimination and violence.
World Health Organization, Working Definition, 2002

How are we doing?
NWT Context:
• What do our indicators look like?
• In what areas is work being done?
• Where do we need to improve?
• What do you think?

Sexually Transmitted Infections (STIs):
101
Bacterial Infections
• Chlamydia *
• Gonorrhea *
• Syphilis *
*Reportable infections

STIs : 101
Viral Infections
• HPV (Human Papilloma Virus)
• Herpes Simplex Virus
• Hepatitis B *
• HIV/AIDS *
• Hepatitis C *
*Reportable infections

STIs : 101
Parasitic Infections
• Pubic Lice
• Scabies (sometimes)
• Trichomonas

Rates per 10,000 population
Rates of STI in the NWT
Incidence rates of STIs, NWT 2000-2010
350
300
250
200
150
100
50
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Chlam 119.6 130.3 143.3 126.6 133.7 166.8 162.0 172.9 199.5 233.9 208.9
Gonor 33.3 37.0 29.3 44.6 31.2 32.5 41.7 50.8 68.2 55.2 50.0
Syph 0.2 0.0 0.0 0.2 0.5 0.0 0.0 0.0 12.1 9.7 1.8
Total 153.2 167.2 172.6 171.5 165.4 199.3 203.7 223.7 279.7 298.8 260.8
Source: Health Protection Unit, Department of Health & Social Services

Rate per 1,000 population
STI Rates- NWT & Canada
(2000 – 2009)
35.0
30.0
NWT
Canada
27.9
29.9
25.0
20.0
15.0
15.4
16.8 17.3 17.2
16.6
20.0
20.4
22.4
10.0
5.0
0.0
1.7 1.8 2.0 2.2 2.3 2.4 2.5 2.6 2.9
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Year
Source: Health Protection Unit, Department of Health & Social Services
Public Health Agency of Canada

Northwest Territories
Sexually Transmitted Infections
2000-2010 (n-9734)
2500
2000
1500
1000
500
0
Female
Male
Source: Health Protection Unit, Department of Health & Social Services

HIV/AIDS in the NWT
1987-2010 Age distribution n=49
30
25
20
26
It can take 5-10 years after
infection before you get sick
15
10
5
0
7
8
4
0 0
2 2
0-9 10-14 15-19 20-29 30-39 40-49 50-59 60+

The reality:
• 19 year old with Chlamydia and Gonorrhea
recently exposed to HIV
– Has a history of STIs for last 5 years
– 10 Known sexual partners (can’t recall all names)

Why?
• Let’s think about the factors that may have
lead to this reality
• What are the impacts – physical, emotional,
social, societal?
• We will come back to this

Sexual Health Initiatives
• Document describes key
elements of a
comprehensive approach to
prevent and control STIs in
the NWT
• Identifies goals, objectives
and actions to aid in raising
awareness
• Key areas of focus: clinical
practice and treatment,
community prevention,
health promotion and
community involvement

Sexual Health Initiatives
• Clinical Practice:
Quarterly audits done by the Health
Protection Unit to assess clinical treatment
and partner notification undertaken by NWT
community health nurses and public health
nurses
87% of cases and contacts successfully
followed-up

Sexual Health Initiatives
• Clinical Case Management
• Outbreak detected 2008
• Response coordinated
through Health Protection
Unit
• Enhanced surveillance,
testing, case finding and
treatment

Sexual Health Initiatives
• Clinical Practice:
Clear guidelines
developed for
practitioners around
cervical cancer
screening, treatment
and follow-up
Path for HPV infection
follow-up

Partnerships

Sexual Health Initiatives
• HPV Vaccine Program:
• Prevention better than cure
• The HPV vaccine prevents cervical cancer. It provides
protection against four types of
HPV virus:
• types 16 and 18 that cause about 70% of cervical
cancers
• types 6 and 11 that cause about 90% of genital warts
• NWT Program started in 2009 – grade 4/5 and
community catch-ups of older girls

Sexual Health Initiatives
• Health Promotion:
• Youth Sexual Health Social Marketing Strategy
-Youth Sexual Health Website
-Youth Sexual Health Comic Book
- Sexual Health Education Lesson Plan Kit

Sexual Health Initiatives
• Youth Sexual Health Website:
•Target Audience: Youth aged 13-
19 years
•Includes resources & links for
teachers
•Q &A section for anonymous
questions
•Updated regularly
•Content, design & website
features guided by input from NWT
youth & Sexual Health Steering
Committee

Sexual Health Initiatives

•Website
•Various
promotional
events in Edzo,
Gameti,
Yellowknife,
Norman Wells, Fort
Smith, Fort
Providence and
visits planned to
Inuvik, Tulita,
Lutselk’e this
spring.
Sexual Health Initiatives

Sexual Health Initiatives
• Sexual Health Comic Book
• Focus group tested with
NWT youth
• Completion date Spring
2011
• Healthy Aboriginal
Network (Vancouver, B.C.)
• Distributed throughout
the territory

Sexual Health Initiatives
• Sexual Health Education Lesson Plan Kit
• Development of educator resource tied to
respectyourself.ca website
• Lesson Plans will be available as PDF’s from website
and in printed and DVD format
• Specific ties to ECE Family Life Curriculum Learning
Outcomes will be identified for educators
• Process guided by steering committee
• Community skill building workshops for educators in
2011-2012

Back to our case study
• 19 year old with Chlamydia and Gonorrhea
recently exposed to HIV
– Has a history of STIs for last 5 years
– 10 Known sexual partners (can’t recall all names)

What’s the impact?
• Physical?
• Body Damage
– PID
– Disseminated Diseases
– Congenital Effects
– Infertility

What else?
• If we think about the holistic
definition of sexual health what are
the other impacts?

The Reality

The Impacts
• What can we do as individual women
and members of our community to
promote safe and healthy sexuality?